Optum is a global organization that delivers care, aided by technology, to help millions of people live healthier lives. The work you do with our team will directly improve health outcomes by connecting people with care, pharmacy benefits, data, and resources they need to feel their best. Here, you will find a culture guided by inclusion, talented peers, comprehensive benefits, and career development opportunities. Come make an impact on the communities we serve as you help us advance health optimization on a global scale. Join us to start Caring. Connecting. Growing together.
This Behavioral Medical Director offers a unique combination of responsibilities and opportunities. The MD will be the Chief Behavioral Medical Officer for a government program MCO serving roughly 50K individuals. As a member of the Executive Leadership Team, the MD will be the primary behavioral representative for clinical activities, quality improvement, utilization management and integrity, compliance, governmental relations, and policy. The MD will work collaboratively with a behavioral team consisting of an Executive Director, Operations/Clinical Director, dedicated UM and CM professionals, as well as other corporate supports. The MD will be a Population Health thought and innovation leader working with peers from other MCOs, State Government, and the Community. While the MD will support UM, it will be done in collaboration with a larger group of physician peers from our Western Region. Secondly, the MD is aligned with a group of Psychiatrists offering clinical oversight and direction to Optum's Clinical team. As a team member, the Behavioral Health Medical Director will collaborate cross-functionally with other Optum and UHG partners to design, build and test clinical models to drive better outcomes and affordability for members with complex needs including those with substance use disorders, behavioral and medical health conditions, and unmet social determinants of health, with a vision to improve member engagement in clinically, cost-effective care. The Behavioral Medical Director is responsible for providing clinical oversight to medical-behavioral integrated (MBI) multidisciplinary teams working to engage members in their recovery. This team uses data and performance metrics to design prototypes assessing interventions, stratification and impact, cost, provider performance, and value creation.
This individual will interact directly with and offer clinical, procedural, or administrative recommendations to psychiatrists and other behavioral health providers, medical physicians and nurses, clinical professionals, and/or state agencies caring for our community. The Behavioral Medical Director is part of a leadership team managing development and implementation of affordable, evidence-based treatments and regional action planning, and advises leadership on health care system improvement opportunities.
Case Management activities include utilization management, case consultation, participation in MBI activities, care engagement-clinical rounds, collaboration with, and participation in the development of case management innovation and evolution. The Behavioral Medical Director participates in quality activities to measure value and promote best practices, including reviewing procedures affecting the quality of care for our members.
The Behavioral Medical Director reports directly to the Senior Medical Director for the West region.
You'll enjoy the flexibility to work remotely from anywhere within the U.S. as you take on some tough challenges.
Ensuring delivery of cost-effective quality care that incorporates evidence-based practices, recovery, resiliency, and person-centered services
Coordination with multiple medical specialties including behavioral, community-based clinicians, specialists, general practitioners, state agencies, and other stakeholders involved in the implementation of a longitudinal care plan
Works as part of an integrated medical-behavioral team that helps coordinate care engagement, care coordination and MBI activities
Provide clinical supervision to the clinical staff, oversee the management of services at all levels of care in the benefit plan
Keep current regarding Evidence Based Practices and treatment philosophies including those that address MBI, equity, trauma-informed care, recovery, and resilience
Maintaining the clinical integrity of the program, including timely peer reviews, documentation, and consultations
Work collaboratively with the Health Plan Executive Leadership Team
Increase interaction, policy making and advocacy with our state partner
Develop collaborative clinical and value-based partnerships w/ providers
Doctor of Medicine or Osteopathy
Current license to practice as a physician without restrictions in the state of New Mexico
Currently reside in New Mexico
Board certified in Psychiatry
Knowledge of post-acute care planning such as home care, discharge planning, case management, and disease management
Demonstrated understanding of the clinical application of the principles of engagement, empowerment, rehabilitation, and recovery
Computer and typing proficiency, data analysis and organizational skills
Ability to participate in rotational weekend call coverage
Board certification in Child and Adolescent Psychiatry; Addiction experience/training
3+ years of experience as a practicing psychiatrist post residency
Managed care experience
Experience in public sector delivery systems and experience in state specific public sector services
Experience working with community-based programs and resources designed to aid the State Medicaid population
Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). No matter where or when you begin a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $258,000 to $423,000 annually based on full-time employment. This role is also eligible to receive bonuses based on sales performance. We comply with all minimum wage laws as applicable.
Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants.